New research has shed light on advancements in implant positioning during revision knee surgery.
A study conducted at the Marshall University Joan C. Edwards School of Medicine and Marshall Health employed a cutting-edge robotic arm system to compare the pre- and post-revision implant positions in a series of revision total knee arthroplasties (TKA).
In a retrospective investigation published in Arthroplasty Today, the orthopaedic team performed 25 revision knee replacements using a robotic-assisted computer system.
The procedure entailed the precise placement of new implants at the thighbone and shinbone extremities, guided by the computer to ensure optimal stability and balance throughout the full range of motion.
The researchers meticulously examined the initial positions of the primary implants. They compared them with the final planned positions of the robotic-assisted revision implants, scrutinising differences in millimetres and degrees.
The analysis revealed that even minute changes in implant position can significantly impact the functionality of knee replacements.
Robotic assistance in revision surgery proves invaluable in detecting these subtle differences.
Furthermore, the computer system aids surgeons in predicting the appropriate implant size and ensures proper knee balance for enhanced stability.
Dr Matthew Bullock, associate professor of orthopaedic surgery and co-author of the study, said: ‘Robotic-assisted surgery has the potential to revolutionise the approach to revision knee replacement. The precision it offers elevates the surgical process and promises improved patient outcomes.’
Loose implants or imbalances often lead to pain and instability, affecting patients’ ability to perform daily activities like walking or climbing stairs.
The study emphasises the critical importance of aligning the prosthesis during revision surgery. It hints at potential advantages, such as appropriately sized implants influencing ligament tension, a crucial factor in functional knee revisions.
Dr Alexander Caughran, assistant professor of orthopaedic surgery and co-author, expressed optimism about the future of robotic revision knee replacement. ‘We continue to collect data for future studies on patient outcomes, anticipating that ongoing research and advancements in artificial intelligence will reshape the landscape of orthopaedic surgery.’
Future research and software iterations will be needed to determine the accuracy and utility of robotic-assisted revision TKA.
Alongside Bullock and Caughran, the co-authors from Marshall University include Dr Micah MacAskill, a resident physician; Dr Richard Peluso, a resident physician; Dr Jonathan Lash, a resident physician; and Dr Timothy Hewett, a professor.
